She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Transformed Their Futures.
In her eighth month of pregnancy and suffering, a woman named Stephanie went to the ER after her infection worsened up her legs. Without a job or home, separated from loved ones, she lived in a shed she had constructed in a acquaintance's garden. She was also dependent on fentanyl.
As medical staff managed her infection, she started to feel anxious. Withdrawal was setting in. She leaned over the bed and threw up.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and use drugs.”
She had taken the drug before coming to the ER and had just enough time to get treated before she was compelled to leave to use once more. She thought she still had four weeks left to figure out how to get clean and give birth.
The nurse had other ideas. She told Stephanie she was not allowed to leave.
“Yes, I am,” Stephanie said.
But the hospital refused to discharge her: the infection in her legs was severe, but physicians found she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she left, she and her baby would be at risk of death.
She encouraged the doctor to give Stephanie controlled doses of fentanyl periodically, knowing that abstinence might harm her and the baby. Once the baby was born Stephanie would be placed on methadone, a treatment that reduces symptoms and is often prescribed in addiction recovery.
After five days, on the 12th of November, Stephanie delivered a daughter weighing just over four pounds – premature, tiny yet healthy.
When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “no.” She was emotionless. Her pain relief did not work, her previous intake of fentanyl had been given four hours before delivery.
She felt unwell. Ill-equipped for parenting. Not fit.
Stephanie had sought recovery multiple times while expecting, and felt terrible each time she failed. She felt hopeless, berating herself for not being able to do the impossible. An doctor told her to “simply” stop using. Even her source would not provide to her when she became clearly expecting.
“However, I failed,” she said. “I needed help.”
The pervasive expectation that her affection for her child would make her quit only led to greater shame and self-abuse, a cause for her to return to drugs. Yet she could not easily command her addiction away, any more than she could will away a chronic disease.
The baby was taken to the NICU. When Stephanie finally saw her her, she was connected to tubes and leads, so little she thought she would break her. Embracing her at last, she felt nothing. “I just stared at her and was like, ‘What am I going to do with you?’” She continued to doubt she wanted to be her mother.
Two days later she decided to name her baby Izzie, after the attendant who showed compassion to her.
Medical personnel told her about a specialized facility, a innovative treatment home where mothers and their drug-exposed newborns are treated together, not apart.
In many parts of America, where a baby is diagnosed with newborn addiction symptoms every 18 minutes, infants are still whisked to NICUs and given drugs while their mothers face custody evaluations. But a developing system of centers like the care home is showing an important truth: when parents and infants remain united, outcomes improve, custody cases decrease and overall savings increase.
It took Stephanie a while to gather the courage to call, but she ultimately reached out. After confirming she would be a good fit for the program, care providers came to bring her to the facility.
She departed the institution still in withdrawal, fearful and unsure about what would follow.
At the facility, Stephanie still feared that CPS would come seize her child – even though she was not sure she wanted to keep her. The concern persisted: that at any point, someone could arrive and take her baby away.
For the initial fortnight, Stephanie remained isolated. “I preferred to be alone,” she said. “I didn’t have a lot of trust at that point.”
Life on the streets, she said, was about survival. Substances came first; faith came last.
Stephanie had one close friend, but even that relationship was delicate. The individuals she cared for always found ways to let her down. She lacked the ability to love herself, not to mention anyone else.
Each day, staff from the center took her to a treatment center, administered in pill form. Slowly, she was beginning recovery.
She utilized each moment outside treatment with Izzie, and could see that her baby was obtaining necessary support she needed. Her daughter struggled with eating at first, with sensitivity to certain foods and pronounced gastrointestinal issues. She needed dietary support. She also had sensory challenges and required an professional – all frequent conditions for babies exposed to substances.
Seeing that even a young person understands the need for care, then I could do this. I could parent.
During a pre-holiday visit, Stephanie remained in the shared space, where parents in active addiction can come for monitored interactions with their babies. An advocate, a peer support specialist, stopped by with her own children in tow to deliver baked goods. They all assembled beside Stephanie, who was sitting on the floor holding Izzie.
The children were wide-eyed in awe of the tiny infant in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They overlooked my addiction. They focused only on the baby.”
She holds a picture of the moment. She is clad in black pants and a hoodie, a cap with a pompom on her head, resting on the floor with the door behind her. She is thin. Her head is tilted forward so you miss her features. She is holding Izzie up on her leg for the children to see and they are gathered around, fawning and reaching out to the baby.
A young boy, eight, asked the parents: “What about the fathers?” The women attempted to clarify that the fathers had obligations, called away to other tasks, that they would be there given the chance.
“In the future,” Jacob said, “I plan to be a great parent. They will know they are valued.”
Stephanie and the specialist exchanged glances. “I became emotional,” Stephanie said. “If this little kid could see that these babies deserve to be loved, then I was able. I could parent.”
Approaches for managing infants affected by substances have been available for years.
The evaluation method was developed in 1975|
